DR. HAZEL E MOORE DDS
NPI 1114914066
Dentist - General Practice in Kenosha, WI

Q: What is Hazel Moore's NPI number?

The NPI number for Hazel Moore is 1114914066. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Q: What is Hazel Moore's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Hazel Moore was last updated on December 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 04, 2005PECOS Enrolled

4536 22ND AVE, KENOSHA, WI 53140(262) 656-0044(262) 653-2218 Get Directions Write a Review

NPPES record last updated: December 29, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Hazel E Moore Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HAZEL E MOORE DDS (NPI 1114914066) is an individual general practice provider in Kenosha, Wisconsin, licensed in Wisconsin (3267-015) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114914066

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. HAZEL E MOORECredential: DDS

Location Address4536 22ND AVEKenosha, WI 53140-5917

Mailing Address5822 Charles StRacine, WI 53402-1824 · (262) 681-2085

Phone(262) 656-0044

Fax(262) 653-2218

Sole ProprietorNo

Enumeration DateOctober 4, 2005

Last NPPES UpdateDecember 29, 2011

✔ NPI 1114914066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 3267-015

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4536 22ND AVE, Kenosha, WI 53140

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Other Identifiers 1

Medicaid33462500WI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Hazel E Moore Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CESAR D GONZALEZ DDS

Dentist (Pediatric Dentistry)